Sunday, November 21, 2010

Drug Dosages and Additional Drug Candidates

Dr. Maguire, UC Irvine, sent the following information regarding drug dosages for asenapine; in addition, he mentions a few other drugs that may have the potential to improve fluency:

Saphris (asenapine) has recently been approved in the EU under the trade name Sycrest. The dosage range we are utilizing at UC Irvine for stuttering are 2.5 mg to 10 mg administered at night. Asenapine does have some significant anti-histamine blockade which can lead to sedating qualities. We have not extensively studied pregabalin in stuttering but one tends to start at a relatively lower dosage in at 50-75 mg twice a day and can increase based on tolerability.

A newer dopamine antagonist, iloperidone, is now available as well. It has not been extensively studied in stuttering yet but is associated with less sedation as it has minimal effects on histamine. It does have an effect on noradrenergic alpha-1 receptors which can lead to dizziness and lowering of blood pressure. Therefore, a titration with beginning at a lower dosage and gradual increase is required. I agree with the author regarding the concern of long-term benzodiazepine use in stuttering.

We are also very excited to begin the use of lurasidone which has also been recently FDA approved for schizophrenia. We need to learn much more about this agent and its potential usefulness in stuttering.

Information regarding the clinical and research program with which Dr. Maguire is associated can be found at the following website as well as the links indicated therein:


Anonymous said...

hi and thanks for the info!

I went to my doctor today about stuttering who basically didnt have a clue, and decided to refer me to a psychiatrist.

I wanted to know more about telemedicine, but clicking on the link in the article just brung up a page on stuttering.

I really want to take part in telemedicine, as ive exhausted my self of talking therapies. what to do?

Great blog!

stutter-mind-body said...

I clicked on the link for the Kirkup Center for the Medical Treatment of Stuttering and got a page with a contact phone number (714 456 5902) and under that phone number was an email link if you wish to communicate by that means.

Your experience with your MD is not unique. They are often reluctant to enter the realm of psychotropic medications (with the exception of SSRI antidepressants).
If your insurance plan doesn't cover psychiatric care or if it offers poor coverage in this area, your best bet would be to go with the Kirkup Center. Good luck in your endeavors.